子宫颈癌复发后治疗方法与预后的关系  

Pel vic Recurrence of Cervical Cancer:the Prognostic Rel ationship to the Retreatment Modalities

作　　者：张晓春[1] 张雪艳[1] 刘爱红[1] 王红[1] 史绍山 

机构地区：[1]山东省肿瘤防治研究院妇科,山东莱西市人民医院肿瘤科

出　　处：《中华妇产科杂志》1995年第10期611-613,共3页Chinese Journal of Obstetrics and Gynecology

摘　　要：本研究分析了１９４例宫颈癌盆腔复发患者初治时临床期别、初治方法、复发部位、复发时间及复发后治疗方法对预后的影响。结果：手术后复发患者中位生存期（２４个月）明显长于手术加放疗后复发患者（１２个月）和放疗后复发患者（１０个月）。初治２年以后复发患者中位生存期（１８个月）明显长于初治２年以内复发患者（１０个月）。再次行放疗和化疗的复发患者中位生存期（２１个月）明显长于单行放疗（１４个月）和单行化疗者（１１个月）。提示：对手术后复发患者首选放疗为主的治疗，效果较好；对有放疗史的复发患者行化疗和（或）放疗效果较差。bjective To investigate the prognostic factors in relation to retreatment modalities in patients wit h recurrent cervical carcinoma.Methods According to initial therapy,19 4 patients with recurrence were grouped as:(1)surgery,22 cases;(2)surgery and radiotherapy,24 cases,and(3) radiotherapy alone,148 cases,Fac-tors such as clinical stage,sites of recurrence, time of diagnosis of recurrence after initial therapy and modalities of retreatment were analyzed.Results There were 19 cases alloted to stageⅠ, 51 cases to stage Ⅱ (Ⅱa 23 and Ⅱb 28)and 124 cases to stage Ⅲ(Ⅲa 2 1 and Ⅲ b 1 03 );histopathologically confirmed squamous cell carcinoma in 1 8 1 cases and adenocarcinoma l3 cases. Central recurrences were found in 91 cases and lateral or pelvic re-currences in 103 cases. Time of diagnosis of recurrence within 2 years from initiaI treatments was shown in 118 patients and above 2 years in 76 patients.In 147 of the 194 patients retreated,those of the group lobtained a median survival rate of 24 months,which was significantly longer than that of group 2,and group 3. The sites of recurrence did not significantly affect the survival。CouclusiOn Radiotherpy remains the treatment of choice for patients with pelvic recurrence after surgery.Previously irradiated patients retreated for recurrence by radiotherapy and(or)chemotherapy had lower response rates.The optima. therapy for these patients should be comprehensive managements including surgery,radiotherapy and chemotherapy.

关 键 词：肿瘤复发 子宫颈肿瘤 预后 药物疗法 外科手术 

分 类 号：R737.330.5[医药卫生—肿瘤]